| NPI | 1700148954 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CALVIN W BYNUM President 559-579-0649 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3245S0500X Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children (Licence: CA 242415) |
| Enumeration Date | 2012-06-13 |
| Last Update Date | 2012-06-13 |